Annual General Meeting 27 th July 2017 Agenda Chairmans Report and - - PowerPoint PPT Presentation

Annual General Meeting 27th July 2017

Agenda

Chairman’s Report and Welcome Andy Meehan Chairman A look back over the year 2016/17 Andy Hardy Chief Executive Officer Summary of the Financial Accounts Susan Rollason Director of Finance and Strategy Summary of the Quality Account Meghana Pandit Chief Medical Officer UHCW Improvement System Neil Griffin Kaizen Promotion Office Lead Questions from the public

Chairman: Andy Meehan Chairman’s Report

Chairman’s Report

• Welcome
• Changes to the Board 2016/17

Chief Executive Officer: Andy Hardy A look back over the year 2016/17

Together Towards World Class

Achievements in the last 12 months

Strategic Objective Achievements To deliver excellent patient care and experience Our scores against the Family and Friends Test have remained high indicating that many of our patients would recommend our hospital To be an employer of choice We have rolled out our bespoke Leadership Programme to our service and team leaders to ensure that we have the capacity and skills to develop our services We have also rolled out values based recruitment and appraisals To deliver value for money We exceeded our Cost Improvement Programme target for the year and achieved our financial plan To be a research based healthcare organisation We have been awarded Clinical Research Facility Status with £750k of funding over the next five-years to support translational and experimental research We have improved the number of patients that are recruited to National Institute of Health Research trials To be a leading training and education centre We have continued to work closely with the University of Warwick and Coventry University and have developed strategies for closer alignment between our organisations

Vital Statistics

2016/17 2015/16

Number of people attending an Outpatient Appointment 656,191 628,452 Number of Outpatient Appointments 712,837 681,609 The number of people attending A&E including those in specialist Children’s A&E 187,792 184,979 The number of Inpatients and Day cases (based on admissions) 163,834 158,189 Babies delivered 6,126 6,254 Patients operated on in theatres 42,709 42,786

2016/17 Highlights

• Adult major trauma outcomes
• HSMR / SHMI
• UHCWi
• Innovation Hub development
• Capital Developments
• IR Suite
• Cath lab
• Rugby sleep study unit
• Clay Lane
• Tommy’s Centre

2017/18 Key Objectives

Director of Finance and Strategy: Su Rollason Summary of Financial Accounts

Financial Performance Overview

• The Trust’s total turnover for 2016/17 amounted to £608.8 million
• In the year 2016/17 the Trust:

– hit the underlying financial control total and secured £16.8m of Sustainability and Transformation Funding, achieving a £0.703m surplus; – exceeded the planned cost improvement plan by £0.3m, achieving £25.8m of savings.

• Our financial performance reflects the hard work of all our staff to deliver high

quality care as efficiently and effectively as possible

Financial Responsibilities

• As a public body there are certain obligations we must fulfil in order to

demonstrate we are being responsible with taxpayers’ money including: – Breaking even (so expenditure does not exceed income): £0.703m surplus (target achieved) – Remaining within the borrowing and capital expenditure limits set by the Department of Health:

• Borrowing: £0.784m undershoot (target met)
• Capital: £0.021m underspend (target met)

– Paying suppliers on time: 93% of invoices paid on time

• As part of this the Trust’s financial accounts are externally checked

(unqualified audit opinion received)

Where did the money come from?

How was the money spent?

Financial Outlook

• The financial pressures on the NHS are set to continue with significant

levels of efficiency savings being required for the foreseeable future

• The Trust has volunteered to participate in the national Financial

Improvement Plan - wave 2. Partnered with PricewaterhouseCoopers a number of opportunities have been identified to achieve efficiencies. The Trust will work in partnership to ensure these are delivered

• The Trust is a very active participant in the Coventry and Warwickshire

Sustainability and Transformation Plan (STP) to ensure the continuing provision of high quality services within the resources available

Chief Medical Officer: Meghana Pandit Quality Account 2016/17

What is the Quality Account?

It is an annual report about the quality of services at UHCW The quality of the services is measured by

• Looking at patient safety
• The effectiveness of treatments that

patients receive

• Patient feedback about the care provided.

Quality is the central principle to all we do here at University Hospitals Coventry and Warwickshire NHS Trust

1.Patient Safety: Increasing the reporting of medication errors and learning from reports.

• The DATIX reporting form has been re-designed as part
• f a Rapid Process Improvement Week (RPIW)
• A Dashboard has also been designed for the specialist

pharmacists to review and present medication error trends at QIPS Meetings. 2.Clinical Effectiveness: Improving Care Bundle Compliance

• Community Acquired Pneumonia, Sepsis Screening Tool

– Adults and Maternal Care Bundles developed 3.Patient Experience: The measurement of direct care using a multi-professional team approach (Care Contact Time)

• A significant proportion of time spent in administering

medications was spent on “non-valued added” tasks:

• Looking at how we can remove ‘non value’ added tasks.

Improvement Priorities 2016-17

Meeting our quality priorities for 2017/18

• Patient Safety
• 15% reduction in patients with avoidable hospital acquired pressure

ulcers.

• 20% reduction in all falls over a 2 year period (2017/18 & 2018/19)

Priority 1 Safety Priority: Eliminating avoidable hospital acquired pressure ulcers and reducing falls

• Clinical Effectiveness
• To continue to maintain HSMR for UHCW at less than 100 over the next

12 months

Priority 2 Clinical Effectiveness Reducing the Trust’s Hospital Standardised Mortality Ratio score

• Patient Experience
• To deliver an engaging, bespoke, world class customer care course for
• ur staff which incorporates latest, best practice in the field ensuring
• ur Trust’s Values and Behaviours’ Framework resonates into practice.

Priority 3 Patient Experience Delivering world class customer care training for staff

Quality Account 2016-17 Highlights

The GTBR Programme involves a review of University Hospital, Coventry (UH) site, and the Hospital of St Cross, Rugby. An agreed set of questions are used to assess the standards that are being achieved. Observations, checking of hospital notes, and asking questions of both staff and patients are used by reviewers. During each round of GTBR, areas for improvement and areas of good practice are noted down by the reviewers. Several positive areas of good practice have emerged:

• Waiting times displayed for patient to see
• Use of team communication board
• ‘Meet and Greet’ poster on display

UHCW was selected by NHS Resolution to participate in a Local Incident Reporting Project, examining the links between patient safety incidents, complaints and legal claims investigations in Obstetrics and Orthopaedics. The project team is analysing data in three parts:

• High level analysis of linked incident, complaint and claims records and current

reporting capabilities in Datix

• Analysis of settled claims with an associated incident and complaint Datix record
• Analysis of settled claims without an associated Datix incident record.

Quality Account at a Glance : Safety Medical Revalidation 84.79% of doctors revalidated Pressure Ulcers 111 patients developed avoidable pressure ulcers Falls Total number of falls of all harm levels for 2016-17 is 253 Serious Incidents (SIs) 139 SI incidents were reported in 2016-2017. Never Events Reported 3 never events in 2016-17. Safeguarding

• 73% of staff have received

PREVENT awareness training

• Training compliance level 1:

93.91%

• Training Compliance level 2:

93.32%

• Child Protection training

compliance level 2: 93.78% UHCWi Patient safety value stream

• Datix incident reporting and

investigation tools streamlined

• Patient Safety Response Team

introduced

• Safety huddles to discuss incidents

Quality Account at a Glance : Effectiveness Audit Participated in 43 national clinical audits and 5 national confidential enquiries. Research and Development

• Recruited 3,789 patients to trials
• 140 research grants submitted
• £4.8m of funding received

Outcomes Framework Performance

• HMSR 101.0 - within expected range
• Admitted/Risk Assessed for VTE –

better than national avg.

• Rate/100,000 bed days of C.diff.

infection – better than national avg.

• Incident reporting – 139 serious

incidents reported including 3 ‘never events’ Infection Prevention and Control

• C.diff. – 29 cases. Target

42.

• MRSA – 0.26/100,000

bed days. Target = 1.03

• MSSA – 8.0/100,000 bed
• days. Target = 10.7.

Quality Account at a Glance : Experience Clinical negligence Reported 90 clinical negligence claims to the NHSLA, a decrease

• f 11 claims on the last financial

year. Complaints

• Received 606 formal

complaints, 66% of which responded to within 25 days. PHSO:

• Referrals: 30. Decided 25;

Upheld 2; Partially upheld 4; Did not uphold 19. Impressions Feedback from patients on services. Consistently in 90%+ range Staff Survey

• Engagement score = 3.83 higher

than national average for acute Trusts

• Percentage of staff agreeing that

their role makes a difference to patients / service users = 92%

• Percentage of staff reporting errors,

near misses or incidents witnessed in the last month = 93% Care contact The Care Contact Team and ICT App to enable the collection and analysis of care contact time easier was shortlisted for the ‘Using Technology to Improve Efficiency’ category at the Health Service Journal’s (HSJ) Value in Healthcare Awards 2016.

Where can the Quality Account be accessed?

• UHCW NHS Trust’s NHS Choices page
• UHCW website: http://www.uhcw.nhs.uk/about-us/annual-report
• Hard copies of the full document are available on request. There is also a summary

document of the Quality Account available. If you would like a copy of either document please ring the Quality Department on 024 7696 5166.

UHCW Improvement System (UHCWi)

The Kaizen Promotion Office Neil Griffin Emma Fish

Our 5 year partnership with Virginia Mason Institute - summary

• Virginia Mason Institute are working

with five NHS Trusts over five years to support an accelerated transformation Programme

• VMI are providing executive and KPO

coaching to all 5 Trusts

• 3 staff from each trust trained in

advanced Lean methodology and created a Kaizen Promotion Office in each Trust

• Developed our own improvement

method – UHCW Improvement System

Create the infrastructure Apply the method Sustain the results

UHCW Improvement System – what does it mean

Learning to understand how our patients experience our services and asking “Are we putting patients first?” Methods and tools to help observe, measure and remove waste and improve processes we work within Empowering those who do the work to improve the systems/processes they work within Promote how we can work in a different way Focuses on behaviours and how collectively we can better know, run and improve our hospital How to observe the workplace – ‘It’s all lies unless you have seen it with your own eyes’

UHCW Value Streams

First areas of work identified by Trust Guiding Team Ophthalmology, Patient Safety Incidents, Theatres, Discharge Value Streams selected based on Putting Patients first Together Towards World Class Programme Aim to be safest hospital in the UK

Ophthalmology Value Stream 1 3 RPIWs :

• Referral

management

• Patient flow in

clinic

• Eye Casualty

Patient safety Incidents Value Stream 2 4 RPIWs:

• Grading
• Serious

incidents

• Investigation –

low harm/no harm incidents

• Actions from

Serious Incidents Theatres Value Stream 3 2 RPIWs

• Assessment on

the day of Surgery

• Delays on the

day of Surgery Simple Discharge Value Stream 4 Just starting…..

Ophthalmology Value Stream

Ophthalmology

• Patients should leave with an

appointment

• Improvement to Clinic set up

– standard tray with necessary items

• Eye Casualty

– testing streaming & improved communication (internet, posters to avoid unnecessary visits), review of staff profile to meet demand Patient safety Incident reporting improvements (time to report, making harm visible to investigator) Improved investigation process

• right person investigates
• contributing factors identified
• In the test areas these are

shared at the huddle. This process has been rolled out to the whole trust during May and June 2017

• Immediate senior response for

serious harm incidents

Patient Safety Value Stream

Theatres Value Stream

Theatres Improvement of privacy & dignity for patients via SODA Changes to documentation for patients who are admitted on the day of surgery via SODA Improvement in processes pre-op and preparing theatre on the day for patients having urology surgery

Case Study Video for Patient Safety Work….. Show video

Engaging staff…putting patients first

Education Sessions & RPIWs Awareness Events 582 staff Masterclass 192 staff RPIW – 5 day workshop (includes 1 day methods and tools) 9 RPIWs Lean for Leaders 84 staff completed or completing a further 100 to start in November this year. Stand up Process owners and Lean For leaders update CO’s on progress and learning.

Lean for Leaders

3 elements:

• Daily management principles –

how to know, run & improve your business.

• Engaging teams to use UHCWi

tools & methods

• Developing a lean culture

Our staff know best how to improve the processes they work within….

“The good thing about this week is that it’s given us time to think and that the people who do the job are actually making the changes”

RPIW participant Dani Johnston Zandra Sutherland HCSW Outpatients Dept

Questions